Krystal A Conkle, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9087-123 Issued in WI

Practice address

32 S Main St
Janesville, WI 53545-3941

Phone

(608) 618-5560

NPI assigned

Feb 6, 2017

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lotus Counseling, LLC

  dba Lotus

  • Clinical Social Worker
  • Janesville, WI
  • NPI 1972077527
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1972041317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 S MAIN ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453941",
            "telephone_number": "608-728-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 S MAIN ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453941",
            "telephone_number": "608-618-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLE",
        "first_name": "KRYSTAL",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130523-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9087-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH",
            "identifier": "9087-123",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stacy M. Condon, LCSW
• Amy M Connell, MD
• Kim N Conrad, CSAC, ICS
• Kara E Considine, PT
• Contemporary Dental
• Barbara Lou Conway, PTA

• Clinical Social Worker in Janesville, WI
• Providers in Janesville, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.